{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:41:47Z","timestamp":1787161307473,"version":"build-2736575974"},"reference-count":64,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T00:00:00Z","timestamp":1628467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The abundance of publications of COVID\u201019\u2010induced chilblains has resulted in a confusing situation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a prospective single\u2010institution study from 15 March to 13 May 2020. Thirty\u2010two patients received PCR nasopharyngeal swabs. Of these, 28 patients had a thoracic CT\u2010scan, 31 patients had blood and urine examinations, 24 patients had skin biopsies including immunohistochemical and direct immunofluorescence studies, and four patients had electron microscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>COVID\u201019\u2010induced chilblains are clinically and histopathologically identical to chilblains from other causes. Although intravascular thrombi are sometimes observed, no patient had a systemic coagulopathy or severe clinical course. The exhaustive clinical, radiological, and laboratory work\u2010up in this study ruled\u2010out other primary and secondary causes. Electron microscopy revealed rare, probable viral particles whose core and spikes measured from 120 to 133\u2009nm within endothelium and eccrine glands in two cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides further clinicopathologic evidence of COVID\u201019\u2010related chilblains. Negative PCR and antibody tests do not rule\u2010out infection. Chilblains represent a good prognosis, occurring later in the disease course. No systemic coagulopathy was identified in any patient. Patients presenting with acral lesions should be isolated, and chilblains should be distinguished from thrombotic lesions (livedo racemosa, retiform purpura, or ischemic acral necrosis).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cup.14099","type":"journal-article","created":{"date-parts":[[2021,7,17]],"date-time":"2021-07-17T03:38:14Z","timestamp":1626493094000},"page":"17-28","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["A clinicopathological description of\n                    <scp>COVID<\/scp>\n                    \u201019\u2010induced chilblains (\n                    <scp>COVID<\/scp>\n                    \u2010toes) correlated with a published literature review"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2542-6935","authenticated-orcid":false,"given":"Athanassios","family":"Kolivras","sequence":"first","affiliation":[{"name":"Department of 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